Children born to mothers who developed preeclampsia appear to have cardiovascular risk factors early in their own lives, researchers found.

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Children born to mothers with preeclampsia appear to have cardiovascular risk factors early in their own lives, this meta-analysis found.

Note that the investigators said that if the systolic difference tracked into adulthood, it would be associated with about an 8% increased risk of death from ischemic heart disease and a 12% increased risk of stroke.

Children born to mothers who developed preeclampsia appear to have cardiovascular risk factors early in their own lives, researchers found.

In a meta-analysis, in-utero exposure to preeclampsia was associated with significant increases in systolic and diastolic blood pressure (P<0.0001 and P<0.00001, respectively) and body mass index (BMI) (P<0.00001) in childhood and adulthood, Paul Leeson, PhD, of John Radcliffe Hospital in Oxford, England, and colleagues reported online in Pediatrics.

For these children, the "predominant phenotype that is now evident in multiple studies is of changes in blood pressure and BMI," they wrote.

It's known that women who develop preeclampsia have a higher risk of cardiovascular disease down the line, but more studies have recently suggested that their offspring may have elevated cardiovascular risks as well.

So Leeson and colleagues conducted a review and meta-analysis of 18 studies with data on 45,249 patients that looked at traditional cardiovascular risk factors in children exposed to preeclampsia compared with controls.

They found that in-utero exposure to preeclampsia was associated with a 2.3-mmHg higher systolic blood pressure (P<0.0001) and a 1.35-mmHg higher diastolic blood pressure (P<0.00001) during childhood and young adulthood.

If the systolic difference tracked into adulthood, they said, it would be associated with about an 8% increased risk of death from ischemic heart disease and a 12% increased risk of stroke.

Leeson and colleagues also found that BMI was increased by 0.62 kg/m2 in children born to mothers with preeclampsia (P<0.00001).

They said the associations were similar in both children and adolescents, for different genders, and with variation in birth weight.

These findings suggest that this population of children may need intensive monitoring and early primary prevention advice, the researchers wrote.

They also looked at other cardiovascular risk markers, but said there was insufficient evidence to draw conclusions about preeclampsia's effects on children's lipid profiles or glucose metabolism.

Some studies did report increases in overall lipid profile, triglycerides, total cholesterol, and low-density lipoprotein (LDL) cholesterol, as well as a drop in high-density lipoprotein (HDL) cholesterol, but there was only a small number of participants for which lipid data were available so they couldn't conduct the meta-analysis, they noted.

Leeson and colleagues noted the study was limited because it couldn't provide insight into the mechanisms underlying the phenotype, and because observational studies are prone to more publication bias than randomized trials.

Additionally, all studies were done in infants born close to term, likely to mothers with less severe preeclampsia, so the results would be different for those with more severe disease.

A greater mechanistic understanding of the differences in blood pressure and BMI may provide useful insights into why some patients are predisposed to hypertension and preeclampsia, they wrote.

"Children born to a pregnancy complicated by preeclampsia appear to have a unique lifetime cardiovascular risk profile that is present from early life, and so may constitute a population that may benefit from risk profile monitoring and early implementation of primary prevention strategies," the researchers concluded.

The study was supported by grants from the British Heart Foundation, the National Institute for Health Research Oxford Biomedical Research Center, and the Oxford British Heart Foundation Center for Research Excellence.

Co-authors were supported by a Clarendon Scholarship and a Commonwealth Scholarship.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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